Introduction:
Lutetium-177-PSMA (Lu-PSMA) is an effective treatment for metastatic castration-resistant prostate cancer (mCRPC) patients, even though the immediate side effects (SE) that can occur during or right after treatment administration are not heavily investigated. Herein, we aimed to report on all adverse events occurring during or shortly after treatment with Lu-PSMA and on independent variables associated with emergency room (ER) visits and hospital admissions.
Methods:
We retrospectively reviewed the medical records of 185 patients with mCRPC who received Lu-PSMA at the Mayo Clinic between April and November 2022. The primary goal of our study is to outline the early side effects reported in the clinical notes, and the secondary goal is to report the emergency room visits and hospitalizations within 30 days following a Lu-PSMA administration. We investigated independent variables associated with ER visits and hospital admissions in univariable and multivariable logistic regression analyses.
Results:
The median(IQR) age at the time of the first Lu-PSMA cycle was 70(67-76)years, with a median(IQR) PSA of 11.8(2.3-76.4)ng/ml. Among known SE attributed to Lu-PSMA, the most observed during or shortly after therapy were gastrointestinal in origin, including nausea 36(19.5%), vomiting 36(19.5%), abdominal pain 17 (9.2%), and constipation 16(8.6%). Other SE included fatigue 54(29.2%), and dry mouth 9(4.9%). In all, 16(8.6%) patients had visited the ER after receiving Lu-PSMA. Out of those 16 patients, 2(1.1%) patients were due to anemia and thrombocytopenia, 2(1.1%) patients had pneumonia and acute respiratory failure, 2(1.1%) patients were due to abdominal pain and vomiting, 2(1.1%) patients presented with sepsis and septic shock, and one(0.5%) patient was due to intestinal obstruction and perforated appendicitis. Additionally, 2(1.1%) patients were hospitalized, due to severe anemia. A high Eastern Cooperative Oncology Group (ECOG) performance score was associated with increased ER visits(p=0.017) and hospital admissions(p=0.007).
Conclusion:
Mild to moderate short-term side effects secondary to treatment with Lu-PSMA are not uncommon, but most patients can be managed in an outpatient setting. A high ECOG performance score was associated with more ER visits and hospital admissions. Larger studies are warranted to further characterize the real-world intensification of care following treatment with Lu-PSMA.
Funding: N/A
Image(s) (click to enlarge):
EARLY ADVERSE EVENTS, EMERGENCY ROOM VISITS AND HOSPITALIZATIONS AFTER PSMA BASED RLT: A RETROSPECTIVE ANALYSIS FROM REAL WORLD THERANOSTICS PRACTICE
Category
Prostate Cancer > CRPC
Description
Poster #27
Wednesday, November 29
4:00 p.m. - 5:00 p.m.
Presented By: Mohamed E. Ahmed
Authors:
Mohamed E. Ahmed
Mohamed E. Ahmed
Ahmad S. Abdelrazek
Daniel S Childs
Geoffrey Johnson
Matthew P Thorpe
Eugene Kwon
A. Tuba Kendi